Displays and claims of understanding in conversation by people with aphasia

Abstract

Background: There is scope for additional research into the specific linguistic and sequential structures used in speech and language therapist (SLT)-led therapeutic conversations with people with aphasia (PWA). Whilst there is some evidence that SLTs use different conversational strategies than the partners of PWA, research to date has focussed mainly on measuring the effects of conversation-based therapies—not on analysing therapeutic conversations taking place between SLTs and PWA.

Aims: This paper presents an analysis of the use of oh-prefacing by some PWA during therapeutic supported conversations with SLTs.

Methods & Procedures: Normally occurring therapeutic conversations between SLTs and PWA after stroke were qualitatively analysed using Conversation Analysis. Interactions with five PWA were video-recorded, involving three different specialist stroke SLTs.

Outcomes & Results: The analysis revealed a difference in the way some PWA use turns that display understanding (e.g., oh right) versus those that continue the conversation, merely claiming understanding (e.g., right). This use of oh-prefacing is similar to that described in the literature on typical conversations. In our data, SLTs are shown to treat oh-prefaced turns differently from non-oh-prefaced turns, by pursuing the topic in the latter, and progressing on to a new topic in the former.

Conclusions: At least some PWA use oh-prefacing in the same way as non-language-impaired adults to display understanding of information versus merely claiming to understand. The SLTs in our data are shown to treat non-oh-prefaced turns as mere claims of understanding by providing the PWA with additional information, using supported conversation techniques, and pursuing additional same-topic talk, whereas oh-prefaced turns are treated as displays of understanding by being confirmed, and leading to changes of topic. This study is a first step in providing SLTs with a clearer understanding of the ways in which they are assessing the understanding of PWA, which may in turn help them better support non-therapy staff.

Keywords:

• Aphasia
• Conversation Analysis
• understanding

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Our thanks to an anonymous reviewer for this wording.

2. The distinction between claiming and displaying understanding goes back to the very beginning of conversation analytic research, being discussed in Sacks’ lectures from 1968 (collected and published decades later; see Sacks, 1992, Vol. 2, p. 141).

3. The quickness of his turn is shown by the latching symbol [=] in the transcript

4. By producing “right” where he does, instead of moving directly into the other-initiation of repair (which he withholds until lines 8–10), Dan also displays an orientation to yet another normative organisation of conversation, the preference for self-repair (Schegloff et al., 1977).

Additional information

Funding

This work was supported by the Centre for Chronic Diseases and Disorders, University of York [grant number A0134312.].